Pancreatic exocrine functionDownloads

A 42-year-old woman is brought to the emergency department because of a 5-day history of epigastric pain, fever, nausea, and malaise. Five weeks ago she had acute biliary pancreatitis and was treated with endoscopic retrograde cholangiopancreatography and subsequent cholecystectomy. Her maternal grandfather died of pancreatic cancer. She does not smoke. She drinks 1–2 beers daily. Her temperature is 38.7°C (101.7°F), respirations are 18/min, pulse is 120/min, and blood pressure is 100/70 mm Hg. Abdominal examination shows epigastric tenderness and three well-healed laparoscopy scars. The remainder of the examination shows no abnormalities. Laboratory studies show: Hemoglobin 10 g/dL Leukocyte count 15,800/mm3 Serum Na+ 140 mEq/L Cl− 103 mEq/L K+ 4.5 mEq/L HCO3- 25 mEq/L Urea nitrogen 18 mg/dL Creatinine 1.0 mg/dL Alkaline phosphatase 70 U/L Aspartate aminotransferase (AST, GOT) 22 U/L Alanine aminotransferase (ALT, GPT) 19 U/L γ-Glutamyltransferase (GGT) 55 U/L (N = 5–50) Bilirubin 1 mg/dl Glucose 105 mg/dL Amylase 220 U/L Lipase 365 U/L (N = 14–280) Abdominal ultrasound shows a complex cystic fluid collection with irregular walls and septations in the pancreas. Which of the following is the most likely diagnosis?

A group of investigators is performing a phase I trial of a novel drug among patients with chronic right upper quadrant pain. Iminodiacetic acid labeled with technetium 99m is administered intravenously and subjects are subsequently imaged with a gamma camera. It is found that administration of the experimental drug increases the amount of iminodiacetic acid in the intestines. The effect of this novel drug is most similar to that of a substance secreted by which of the following cells?